心房容积追踪技术评估胎儿心房容积及功能的初步研究

Evaluation of left and right atrial volumes and functions of fetuses in second and late trimester of pregnancy by atrial volume tracking

目的探讨心房容积追踪技术（atrialvolumetracking，AVT）定量中晚孕期胎儿左、右心房容积及评估左、右心房功能的方法学及可行性。方法选取176例胎儿作为研究对象。获取胎儿标准四腔心观后，启动AVT，获得左、右心房容积变化曲线，然后取得左、右心房最大容积（LAVmax、RAVmax）、最小容积（LAVmin、RAVmin）及排空分数（LAEF、RAEF）。应用Pearson相关分析LAVmax、RAVmax、LAVmin、RAVmin、LAEF、RAEF与孕周的相关性。结果RAVmax、LAVmax、RAVmin、LAVmin与孕周呈生长曲线相关（r=0．80、0．85、0．83、0．82，P〈0．001），右心房容积大于左心房（P〈0．01）。RAEF、LAEF与孕周无显著相关性，且两者无明显差异（均P〉0．05）。结论AVT技术可以用于中晚孕期正常胎儿的心房容积自动定量；胎儿LAVmax、LAVmix、RAVmax、RAVmin均随孕周增长而增加，这与胎儿心脏生长发育的基本规律是一致的，中晚孕期正常胎儿心房功能相对稳定。

Objective To evaluate the left atrial（LA） and right atrial（RA） volumes and functions of fetuses in second and late trimester by using atrial volume tracking （AVT）. Methods One hundred and seventy-six fetuses were enrolled in this study. Using AVT, the maximal and minimal volumes of RA and LA were measured from time-atrial volume tracking curves. RA and LA ejection fraction （RAEF and LAEF） derived from the value of atrial maximal volumes（ LAVmax, RAVmax） subtracted atrial minimal volumes （LAVmin, RAVmin） and divided by LAVmax or RAVmax. Pearson correlation analysis was used to analyze the relationships between LAVmax, RAVmax, LAVmin, RAVmin, LAEF, RAEF and gestational ages. Results For all normal cases, the volumes of LA and RA were closely correlated with gestational weeks（ r = 0.80,0.85,0.83,0.82, P 〈0. 001）. The volume of LA was significantly smaller than that of RA （ P 〈0.01）. The RAEF and LAEF remained stable with advancing gestational age and there was no significantly difference between RAEF and LAEF （ P 〈~0.05）. Conclusions This study establishes normal reference values for fetal RA and LA volumes during the second and third trimesters of pregnancy. The volumes of RA and LA are correlated with gestational weeks, and the volume of RA is bigger than that of LA. RAEF and LAEF are uncorrelated with gestational weeks, and there＇s no difference between RVEF and LAEF.